HIPS KNEES ANKLES ELBOWS SHOULDERS

Unit-level activity and outcomes National Joint Registry

17th Annual Report 2020 Surgical data to 31 December 2019 ISSN 2054-183X (Online) National Joint Registry | 17th Annual Report

Unit performance SRR is 1, the number of revisions is compatible with the number expected for that unit. This section shows indicators for hip and knee joint replacement procedures by trust, local health board • Control limits for funnel plots are normally set at and unit (hospital). This was first included in 2012 and 95% and 99.8% (approximates to 2 or 3 standard is part of the Government’s transparency agenda. deviations). Our normal six-monthly review process It is based on procedures carried out during the focuses on those above the upper limit of the latter. 2019 calendar year and submitted to the NJR by 29 One might expect, however, that one in 500 would February 2020. be outside the 99.8% limits (above or below) just by chance. In the following table we have highlighted in Hospital information (excluding outlier analysis) is red (1) units above the upper of the 99.8% control based on the actual operation date (1 January 2019 limits. Previously we have reported on those units to 31 December 2019). Where hospitals were open above the 99.99% control limits, but this has now been in 2019 for orthopaedic procedures but have not removed from the report. submitted data to the NJR, they are included in the Summary of the methodology for unit 90-day following table but with no procedure data. mortality rates:

At the time of publication, it has not been possible to • The standardised mortality ratio (SMR) is plotted produce compliance figures for the financial year 1 against number of expected deaths. The SMR is the April 2019 to 31 March 2020 due to the unavailability number of actual deaths within 90 days of primary of data from the Hospital Episodes Statistics (HES) joint replacement, divided by the number of expected service. deaths in this period. The number of expected deaths has been calculated after adjustment for Unit outlier analysis methodology patient characteristics (age, gender and ASA grade Unit outlier analysis covers all primary procedures of patients). Analysis for hips has excluded operations performed from 15 February 2010 to 14 February undertaken for trauma, failed hemi-arthroplasty and, 2020. since November 2014 (when recording of this began), hips implanted for metastatic cancer. Unit outlier analysis covers all primary procedures • Control limits are as for revisions above performed from 15 February 2010 to 14 February 2020. Any units identified as potential outliers have been The outlier analyses made use of funnel plots from notified. All units are provided with their NJR Annual statistical process control methodology. These aim Clinical Report and additionally have access to NJR’s to distinguish normal variation between units (which online NJR Management Feedback system which is is to be expected) from unusual differences (termed updated annually. ‘special cause’ variation), which may indicate the need for further investigation. Funnel plots enable units of In earlier Annual Reports, the NJR has reported different sizes to be compared; performance indicators outlying hospitals based on all cases submitted to the based on smaller numbers of patients will have greater NJR since April 2003. To reflect changes in hospital variability and this in turn is reflected by wider control practices and component use, the NJR now reports limits. outlying hospitals based on the last ten years (15 February 2010 to 14 February 2020 inclusive) and five Summary of the methodology for unit revision rates: years of data (15 February 2015 to 14 February 2020 • The standardised revision ratio (SRR) is plotted against inclusive). These cuts of data exclude the majority the number of expected revisions. The SRR is the total of withdrawn outlier implants and metal-on-metal number of revisions divided by the number of expected total hip replacements from analysis, and thus better revisions for that unit’s caseload in respect of the age represent contemporary practice. group, gender and the diagnosis of the patients. If the

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Please note for the data in the following table: Consent and Linkability are: Red if lower than 80% Amber if equal to or greater than 80% and lower than 95% Green if 95% or more • Linkability for some hospitals will be lower than expected if they have private patients from outside England and Wales • Data covers procedures carried out between 1 January 2019 and 31 December 2019 Outlier analyses are: Red if units are above the upper of the 99.8% control limits (approximates to 3 standard deviations (SDs)) Green if units are within the expected range..

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid patient’s NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Aintree University Hospitals NHS Foundation Trust Aintree University Hospital Sefton Suite 18 2 78% 94% 1.9 53% 69.3 University Hospital Aintree 479 21 96% 99% 2.3 44% 68.4 ∆ Airedale NHS Foundation Trust Airedale General Hospital 464 7 98% 100% 2.5 35% 72.2 Aneurin Bevan Health Board Nevill Hall Hospital 915 11 97% 100% 2.3 40% 70.1 ∆ Royal Gwent Hospital 439 16 100% 100% 2.4 37% 72.3 St Woolos Hospital 999 20 98% 98% 2.0 42% 68.4 Ysbyty Ystrad Fawr 8 2 100% 100% 1.9 50% 63.8 Ashford and St Peter's Hospitals NHS Foundation Trust Ashford Hospital 833 16 93% 99% 2.0 40% 70.4 ∆ St Peter's Hospital 94 14 93% 99% 2.6 34% 75.4 Barking Havering and Redbridge University Hospitals NHS Trust King George Hospital 575 14 89% 99% 2.3 39% 70.8 Queens Hospital 69 16 26% 90% 2.6 32% 75.4 Barnsley Hospital NHS Foundation Trust Barnsley District General Hospital 683 8 91% 98% 2.2 47% 68.8

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Barts Health NHS Trust Gateway Surgical Centre 352 20 95% 99% 2.0 33% 66.2 Newham General Hospital 2 1 100% 100% 2.5 0% 70.4 The Royal Hospital 255 16 99% 99% 2.5 47% 68.4 Whipps Cross University Hospital 236 10 98% 99% 2.4 37% 72.0 Basildon and Thurrock University Hospitals NHS Foundation Trust Basildon University Hospital 626 12 70% 97% 2.5 39% 71.5 Bedford Hospital NHS Trust Bedford Hospital South Wing 477 8 94% 97% 2.4 43% 70.8 HSC Trust Musgrave Park Hospital 2541 38 100% 100% 2.1 43% 67.9 Royal Victoria Hospital 171 18 62% 60% 2.4 26% 70.2 Betsi Cadwaladr University Health Board Abergele Hospital 543 9 100% 100% 2.0 42% 70.1 ∆ Glan Clwyd General Hospital 259 8 100% 100% 2.7 46% 74.3 Wrexham Maelor Hospital 593 10 97% 99% 2.2 40% 70.4 ∆ Ysbyty Gwynedd 609 9 93% 99% 2.4 43% 70.4 Blackpool Teaching Hospitals NHS Foundation Trust Blackpool Victoria Hospital 349 13 93% 97% 2.3 38% 71.0

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Bolton NHS Foundation Trust Royal Bolton Hospital 456 10 76% 96% 2.5 35% 70.0 Bradford Teaching Hospitals NHS Foundation Trust Bradford Royal Infirmary 545 10 98% 99% 2.2 40% 68.3 and Sussex University Hospitals NHS Trust Princess Royal Hospital 172 14 59% 97% 2.6 43% 74.2 Royal Sussex County Hospital 38 7 58% 87% 2.4 48% 72.1 Sussex Orthopaedic NHS Treatment Centre 704 21 95% 98% 2.2 40% 70.1 ∆ ∆ ∆ Buckinghamshire Healthcare NHS Trust Stoke Mandeville Hospital 57 7 58% 84% 2.3 38% 75.0 Wycombe Hospital 714 10 95% 99% 2.2 39% 70.9 Calderdale and Huddersfield NHS Foundation Trust Calderdale Royal Hospital 903 13 98% 100% 2.3 42% 70.0 Huddersfield Royal Infirmary 45 10 67% 91% 2.2 39% 72.1 Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital 827 20 98% 98% 2.4 40% 71.1 and Vale University Health Board University Hospital Llandough 1343 18 95% 96% 2.1 42% 68.8 ∆ University Hospital of Wales 39 6 0% 97% 2.5 37% 74.5

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Chelsea and Westminster Hospital NHS Foundation Trust Chelsea and Westminster Hospital 452 11 80% 98% 2.0 36% 69.5 West Middlesex University Hospital 375 7 99% 99% 2.2 41% 69.4 Chesterfield Royal Hospital NHS Foundation Trust Chesterfield Royal Hospital 673 13 88% 98% 2.1 43% 70.5 ∆ City Hospitals Sunderland NHS Foundation Trust Sunderland Royal Hospital 1018 12 97% 99% 2.3 43% 68.5 Countess of Chester Hospital NHS Foundation Trust Countess of Chester Hospital 402 10 99% 99% 2.1 39% 71.7 County Durham and Darlington NHS Foundation Trust Bishop Auckland Hospital 608 17 78% 99% 2.1 45% 68.3 Darlington Memorial Hospital 185 9 68% 89% 2.5 31% 71.3 University Hospital of North Durham 307 9 82% 98% 2.5 43% 71.5 Croydon Health Services NHS Trust Croydon University Hospital 34 9 88% 91% 2.3 26% 72.4 Cwm Taf Morgannwg Health Board Prince Charles Hospital 258 5 99% 100% 2.4 39% 71.6 Princess of Wales Hospital 607 10 94% 96% 2.3 42% 71.1

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 The Royal Glamorgan Hospital 535 10 98% 99% 2.3 46% 69.2 Dartford and Gravesham NHS Trust Darent Valley Hospital 627 10 99% 100% 2.5 38% 71.6 Queen Mary's Hospital Sidcup 458 9 99% 100% 2.1 44% 67.2 Doncaster and Bassetlaw Hospitals NHS Foundation Trust Bassetlaw Hospital 324 11 91% 97% 2.5 38% 70.7 Doncaster Royal Infirmary 454 15 86% 96% 2.5 42% 69.9 Dorset County Hospital NHS Foundation Trust Dorset County Hospital 578 11 88% 99% 2.3 41% 71.6 East and North Hertfordshire NHS Trust Lister Hospital 815 16 95% 98% 2.3 42% 72.1 East Cheshire NHS Trust Macclesfield District General Hospital 370 8 97% 100% 2.2 40% 71.3 East Kent Hospitals University NHS Foundation Trust Kent and Canterbury Hospital 1085 14 90% 98% 2.2 41% 70.8 Queen Elizabeth The Queen Mother 690 12 75% 98% 2.3 38% 71.6 ∆ Hospital William Harvey Hospital (Ashford) 191 18 75% 94% 2.3 36% 73.2 East Lancashire Hospitals NHS Trust Burnley General Hospital 846 19 99% 99% 2.3 45% 69.7 Royal Blackburn Hospital 109 18 67% 99% 2.7 39% 73.8

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 East Suffolk and North Essex NHS Foundation Trust Colchester General Hospital 864 11 93% 100% 2.2 39% 72.0 ∆ Ipswich Hospital 680 12 96% 99% 2.1 44% 71.8 East Sussex Healthcare NHS Trust Conquest Hospital 698 13 95% 96% 2.2 42% 71.9 Eastbourne District General Hospital 394 5 98% 98% 2.4 40% 72.7 Epsom and St Helier University Hospitals NHS Trust Epsom Hospital 22 1 91% 100% 2.3 36% 72.3 St Helier Hospital 13 6 54% 100% 2.6 23% 62.0 The Elective Orthopaedic Centre 3098 41 97% 97% 2.1 38% 69.8 Frimley Health NHS Foundation Trust Frimley Park Hospital 1312 18 94% 98% 2.2 40% 69.9 Heatherwood Hospital 799 14 99% 100% 2.1 37% 69.8 ∆ ∆ Wexham Park Hospital 240 18 81% 98% 2.5 35% 72.2 Gateshead Health NHS Foundation Trust The North East NHS Surgery Centre 891 17 91% 99% 2.3 43% 68.9 ∆ George Eliot Hospital NHS Trust George Eliot Hospital - Acute Services 403 6 91% 99% 2.3 46% 70.5 Gloucestershire Hospitals NHS Foundation Trust Cheltenham General Hospital 1740 17 99% 100% 2.2 41% 70.8

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Gloucestershire Royal Hospital 176 19 61% 97% 2.3 30% 73.7 Great Western Hospitals NHS Foundation Trust The Great Western Hospital 1018 17 91% 96% 2.4 40% 70.2 Guy's and St Thomas' NHS Foundation Trust Guy's Hospital 915 16 88% 91% 2.2 39% 62.8 ∆ ∆ St Thomas' Hospital 34 7 65% 62% 2.2 14% 64.4 Hampshire Hospitals NHS Foundation Trust Basingstoke and North Hampshire Hospital 871 17 85% 94% 2.1 42% 70.4 ∆ Royal Hampshire County Hospital 414 11 73% 96% 2.3 40% 71.8 Harrogate and District NHS Foundation Trust Harrogate District Hospital 1016 11 91% 93% 2.1 42% 70.1 Homerton University Hospital NHS Foundation Trust Homerton University Hospital 231 6 98% 99% 2.2 33% 66.8 ∆ ∆ Hull and East Yorkshire Hospitals NHS Trust Castle Hill Hospital 1052 20 79% 95% 2.2 43% 69.4 Hull Royal Infirmary 82 17 74% 85% 2.3 34% 71.1 Hywel Dda Health Board Bronglais General Hospital 227 3 95% 100% 2.2 41% 70.9

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Prince Philip Hospital 893 11 99% 100% 2.1 44% 69.3 West Wales General Hospital 47 8 87% 100% 2.3 38% 73.5 Withybush General Hospital 373 8 97% 99% 2.2 43% 70.5 Imperial College Healthcare NHS Trust Charing Cross Hospital 714 22 93% 98% 2.2 39% 68.1 ∆ St Mary's Hospital 45 10 71% 89% 2.2 40% 66.7 Isle of Man Secondary Healthcare Directorate Noble's Hospital 190 4 99% 98% 2.0 50% 69.4 Isle of Wight NHS Trust St Mary's Hospital 509 6 99% 99% 2.3 37% 72.3 ∆ James Paget University Hospitals NHS Foundation Trust James Paget University Hospital 925 9 90% 99% 2.4 42% 71.0 Kettering General Hospital NHS Foundation Trust Kettering General Hospital 722 11 95% 100% 2.3 42% 70.3 King's College Hospital NHS Foundation Trust King's College Hospital (Denmark Hill) 113 17 85% 89% 2.4 36% 70.1 Orpington Hospital 944 26 72% 91% 2.1 38% 69.3 Princess Royal University Hospital 79 13 54% 70% 2.7 35% 77.6

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Kingston Hospital NHS Foundation Trust Kingston Hospital 39 10 82% 79% 2.3 29% 71.0 Lancashire Teaching Hospitals NHS Foundation Trust Chorley and South Ribble Hospital 583 12 94% 97% 2.5 45% 70.2 Royal Preston Hospital 67 15 73% 100% 2.6 43% 73.9 Teaching Hospitals NHS Trust Chapel Allerton Hospital 998 21 94% 99% 2.3 43% 68.5 Leeds General Infirmary 29 5 66% 86% 2.3 28% 64.4 and Greenwich NHS Trust Queen Elizabeth Hospital Woolwich 8 4 75% 100% 2.3 50% 69.1 Riverside Treatment Centre 252 15 72% 92% 2.2 33% 69.0 ∆ University Hospital Lewisham 190 15 75% 92% 2.2 38% 68.7 London North West University Healthcare NHS Trust Central Middlesex Hospital 890 21 95% 98% 2.1 38% 69.7 Ealing Hospital 15 3 73% 100% 2.7 33% 66.6 ∆ Northwick Park Hospital 55 10 27% 93% 2.4 29% 68.5 Luton and Dunstable Hospital NHS Foundation Trust Luton and Dunstable Hospital 550 10 91% 99% 2.3 40% 70.6

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Maidstone and Tunbridge Wells NHS Trust Maidstone District General Hospital 572 12 99% 99% 2.2 44% 70.7 The Tunbridge Wells Hospital 402 19 97% 99% 2.4 38% 74.3 University NHS Foundation Trust Manchester Royal Infirmary 78 13 88% 91% 2.7 34% 65.4 Royal Manchester Childrens Hospital 4 1 50% 100% 2.5 0% 14.8 Trafford General Hospital 915 39 85% 87% 2.2 40% 68.7 Wythenshawe Hospital 555 14 90% 99% 2.2 39% 69.8 Medway NHS Foundation Trust Medway Maritime Hospital 549 10 82% 100% 2.5 39% 70.3 Mid Cheshire Hospitals NHS Foundation Trust Leighton Hospital 731 10 98% 100% 2.1 39% 70.7 Mid Essex Hospital Services NHS Trust Braintree Community Hospital 284 13 100% 99% 2.1 37% 70.0 Broomfield Hospital 393 11 100% 99% 2.5 39% 72.3 Mid Yorkshire Hospitals NHS Trust Dewsbury and District Hospital 332 9 94% 95% 2.2 44% 69.3 Pinderfields General Hospital 341 13 91% 96% 2.5 38% 70.4 Pontefract Elective Unit (Treatment Centre) 563 12 98% 98% 2.2 47% 68.0

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

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Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Milton Keynes Hospital NHS Foundation Trust Milton Keynes Hospital 523 11 98% 98% 2.2 36% 69.2 ∆ ∆ Norfolk and Norwich University Hospitals NHS Foundation Trust Norfolk and Norwich Hospital 957 17 97% 99% 2.5 41% 71.8 Northampton General Hospital NHS Trust Northampton General Hospital (Acute) 590 14 99% 100% 2.4 39% 71.4 North Bristol NHS Trust Southmead Hospital 1660 30 96% 99% 2.4 40% 69.0 ∆ ∆ North Cumbria Integrated Care NHS Foundation Trust Cumberland Infirmary 295 10 84% 99% 2.3 38% 72.4 West Cumberland Hospital 361 15 94% 99% 2.2 45% 71.3 Northern Devon Healthcare NHS Trust North Devon District Hospital 636 12 99% 100% 2.3 45% 71.7 Northern Lincolnshire and Goole Hospitals NHS Foundation Trust Diana Princess of Wales Hospital 559 12 93% 97% 2.5 41% 71.3 ∆ Goole and District Hospital (Acute) 394 11 85% 97% 2.3 46% 68.8 Scunthorpe General Hospital 4 2 75% 100% 2.3 0% 67.6

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

14 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 North Middlesex University Hospital NHS Trust North Middlesex Hospital 256 10 100% 100% 2.4 41% 69.7 North Tees and Hartlepool NHS Foundation Trust University Hospital of Hartlepool 763 8 99% 100% 2.2 45% 68.2 University Hospital of North Tees 153 11 95% 99% 2.7 45% 71.3 Northumbria Healthcare NHS Foundation Trust Hexham General Hospital 1039 18 100% 100% 1.9 46% 69.4 ∆ ∆ North Tyneside General Hospital 787 17 99% 99% 2.0 45% 68.8 ∆ ∆ Northumbria Specialist Emergency Care 305 20 91% 98% 2.5 43% 72.8 Hospital Wansbeck Hospital 1211 17 100% 100% 2.1 44% 69.4 ∆ ∆ North West Anglia NHS Foundation Trust Hinchingbrooke Hospital 654 12 100% 100% 2.3 41% 71.5 ∆ Peterborough City Hospital 777 11 97% 97% 2.3 45% 70.7 Nottingham University Hospitals NHS Trust Nottingham City Hospital 1806 19 97% 99% 2.3 45% 69.1 ∆ Nottingham Treatment Centre 379 9 99% 99% 2.3 40% 68.7 Queens Medical Centre Nottingham 54 14 93% 96% 2.3 29% 67.0 University Hospital

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

15 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Oxford University Hospitals NHS Trust Horton General Hospital 23 4 74% 100% 2.3 30% 75.9 John Radcliffe Hospital 60 8 80% 97% 2.1 22% 73.8 Nuffield Orthopaedic Centre 1977 26 96% 98% 2.2 43% 69.5 ∆ ∆ Pennine Acute Hospitals NHS Trust Fairfield General Hospital 1198 24 100% 100% 2.2 43% 69.2 North Manchester General Hospital 67 12 93% 99% 2.4 44% 74.1 Royal Oldham Hospital 56 8 82% 93% 2.5 31% 72.9 Plymouth Hospitals NHS Trust Derriford Hospital 573 18 84% 98% 2.6 42% 70.9 Poole Hospital NHS Foundation Trust Poole Hospital 112 12 82% 94% 2.4 30% 75.9 Hospitals NHS Trust Queen Alexandra Hospital 1633 23 99% 99% 2.2 42% 71.5 Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust Robert Jones and Agnes Hunt 3648 30 98% 99% 2.1 47% 69.5 Orthopaedic Hospital Royal Berkshire NHS Foundation Trust Royal Berkshire Hospital 1052 18 74% 96% 2.2 40% 71.1

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

16 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Royal Cornwall Hospitals NHS Trust Royal Cornwall Hospital (Treliske) 126 15 78% 95% 2.4 24% 72.4 St Michael's Hospital 841 19 96% 99% 2.2 44% 69.2 Royal Devon and Exeter NHS Foundation Trust Royal Devon and Exeter Hospital (Wonford) 1717 22 96% 98% 2.1 39% 70.3 Royal Free London NHS Foundation Trust Barnet Hospital 111 15 40% 98% 2.6 34% 74.9 Chase Farm Hospital 872 22 90% 96% 2.2 34% 69.8 The Royal Free Hospital 138 9 86% 97% 2.5 39% 70.9 Royal and Broadgreen University Hospitals NHS Trust Alder Hey Childrens Hospital 2 1 100% 100% 1.5 50% 15.8 Broadgreen Hospital 620 17 98% 100% 2.3 44% 68.9 ∆ The Royal Liverpool University Hospital 87 12 85% 100% 2.7 48% 73.1 Royal National Orthopaedic Hospital NHS Trust The Royal National Orthopaedic Hospital 1302 31 96% 98% 2.2 40% 64.3 ∆ (Stanmore) Royal Surrey County Hospital NHS Foundation Trust Royal Surrey County Hospital 705 14 100% 99% 2.2 41% 72.1 Royal United Hospital Bath NHS Trust Royal United Hospital 641 18 91% 99% 2.5 40% 72.0

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

17 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Salford Royal NHS Foundation Trust Salford Royal 182 22 100% 100% 2.6 46% 69.8 Salisbury NHS Foundation Trust Salisbury District Hospital 746 12 94% 94% 2.1 41% 71.0 ∆ ∆ Sandwell and West Hospitals NHS Trust City Hospital N/A6 Sandwell General Hospital 1023 22 98% 99% 2.2 40% 69.3 Teaching Hospitals NHS Foundation Trust Northern General Hospital 631 23 87% 98% 2.4 43% 69.0 Royal Hospital 875 17 97% 99% 2.4 42% 69.4 Sherwood Forest Hospitals NHS Foundation Trust Kings Mill Hospital 800 15 99% 100% 2.4 45% 69.3 Shrewsbury and Telford Hospital NHS Trust Royal 30 6 100% 100% 2.5 33% 76.3 The Princess Royal Hospital 324 8 93% 93% 2.3 44% 71.5 South Eastern HSC Trust Ulster Hospital Dundonald 74 6 99% 97% 2.5 21% 71.9 Southend University Hospital NHS Foundation Trust Southend Hospital 257 10 72% 100% 2.4 44% 70.7

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

18 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Southern HSC Trust Craigavon Area Hospital 514 12 95% 95% 2.3 43% 68.7 Southport and Ormskirk Hospital NHS Trust Ormskirk and District General Hospital 280 9 90% 100% 2.1 42% 73.0 ∆ Southport and Formby District General 54 11 67% 98% 2.3 28% 76.3 Hospital South Tees Hospitals NHS Foundation Trust Friarage Hospital 722 17 100% 100% 2.0 45% 69.3 The James Cook University Hospital 631 21 98% 99% 2.3 43% 69.7 South Tyneside NHS Foundation Trust South Tyneside District Hospital 246 5 96% 100% 2.1 45% 70.7 ∆ ∆ South Warwickshire NHS Foundation Trust Warwick Hospital 1213 16 96% 97% 2.1 39% 70.7 St George's Healthcare NHS Trust St George's Hospital (Tooting) 110 15 100% 100% 2.7 32% 73.0 St Helens and Knowsley Hospitals NHS Trust Whiston Hospital 808 14 84% 98% 2.3 40% 69.1 Stockport NHS Foundation Trust Stepping Hill Hospital 821 13 96% 98% 2.3 35% 71.5

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

19 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Surrey and Sussex Healthcare NHS Trust East Surrey Hospital 274 14 78% 98% 2.3 38% 72.6 Bay University Local Health Board Morriston Hospital 360 15 83% 90% 2.5 44% 71.8 Neath Port Talbot Hospital 326 14 93% 98% 2.0 45% 69.9 Tameside Hospital NHS Foundation Trust Tameside General Hospital 562 12 100% 100% 2.3 37% 69.9 Taunton and Somerset NHS Foundation Trust Musgrove Park Hospital 576 9 98% 98% 2.6 43% 71.5 The Dudley Group of Hospitals NHS Foundation Trust Russells Hall Hospital 924 12 86% 99% 2.3 43% 71.3 The Hillingdon Hospital NHS Foundation Trust Hillingdon Hospital 102 13 75% 92% 2.6 31% 74.9 ∆ ∆ Mount Vernon Treatment Centre 489 10 93% 97% 2.2 38% 69.9 ∆ The Newcastle Upon Tyne Hospitals NHS Foundation Trust Freeman Hospital 1051 14 82% 88% 2.4 44% 68.6 The Royal Victoria Infirmary 112 9 64% 90% 2.6 28% 73.0 The Princess Alexandra Hospital NHS Trust Princess Alexandra Hospital 711 9 93% 95% 2.3 42% 71.1

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

20 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust The Queen Elizabeth Hospital 547 9 95% 100% 2.6 38% 71.8 The Rotherham NHS Foundation Trust Rotherham District General Hospital 723 11 100% 100% 2.2 40% 70.9 The Royal Bournemouth And Christchurch Hospitals NHS Foundation Trust Royal Bournemouth Hospital 1632 14 98% 99% 2.1 41% 71.0 The Royal Orthopaedic Hospital NHS Foundation Trust Royal Orthopaedic Hospital 2245 30 97% 98% 2.1 41% 67.3 The Royal Wolverhampton Hospitals NHS Trust Cannock Chase Hospital 1302 17 98% 99% 2.1 42% 69.4 New Cross Hospital 252 19 62% 89% 2.8 49% 75.7 The Whittington Hospital NHS Trust The Whittington Hospital 363 9 69% 97% 2.2 32% 68.1 Torbay South Devon NHS Foundation Trust Torbay Hospital 728 16 94% 96% 2.5 40% 71.5 United Lincolnshire Hospitals NHS Trust Grantham and District Hospital 1123 22 91% 97% 2.0 44% 70.0 Lincoln County Hospital 119 9 79% 94% 2.5 34% 73.4 Pilgrim Hospital 199 16 83% 96% 2.6 36% 72.7

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

21 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 University College London Hospitals NHS Foundation Trust University College Hospital 839 16 83% 93% 2.2 36% 64.3 ∆ University Hospitals Birmingham NHS Foundation Trust Good Hope Hospital 369 18 95% 98% 2.3 44% 72.2 Heartlands Hospital 28 9 25% 93% 2.5 35% 73.9 Queen Elizabeth Hospital Birmingham 56 8 73% 88% 2.2 41% 73.8 Solihull Hospital 977 29 94% 94% 2.2 42% 70.1 University Hospitals Bristol NHS Foundation Trust Bristol Royal Hospital for Children 2 1 100% 100% 1.5 50% 13.6 Bristol Royal Infirmary 39 4 62% 92% 2.3 11% 74.0 University Hospitals Coventry and Warwickshire NHS Trust Hospital of St Cross 1327 25 89% 96% 2.1 40% 68.0 University Hospital (Coventry) 386 26 91% 98% 2.6 39% 69.7 ∆ University Hospitals of Derby and Burton NHS Foundation Trust Queens Hospital Burton Upon Trent 906 9 91% 99% 2.4 41% 70.0 Royal Derby Hospital 1783 24 93% 97% 2.2 39% 70.0 University Hospitals of NHS Trust Leicester General Hospital 1685 23 93% 96% 2.4 40% 70.1 Leicester Royal Infirmary 38 13 71% 89% 2.4 38% 71.9

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

22 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 University Hospitals of Morecambe Bay NHS Foundation Trust Furness General Hospital 365 9 96% 99% 2.3 42% 70.7 Royal Lancaster Infirmary 280 16 99% 100% 2.4 40% 72.5 Westmorland General Hospital 574 19 98% 99% 2.0 46% 70.1 University Hospitals of North Midlands NHS Trust County Hospital 715 15 96% 100% 2.4 40% 70.1 Royal Stoke University Hospital 593 16 100% 99% 2.5 42% 71.2 University Hospital Southampton NHS Foundation Trust Southampton General Hospital 697 22 96% 99% 2.4 41% 71.2 ∆ ∆ ∆ Walsall Healthcare NHS Trust Manor Hospital 414 9 92% 100% 2.2 43% 70.6 Warrington and Halton Hospitals NHS Foundation Trust The Cheshire and Merseyside Treatment 618 10 97% 98% 2.2 43% 69.3 Centre Warrington Hospital 62 8 81% 98% 2.7 39% 73.0 Western HSC Trust Altnagelvin Area Hospital 446 14 99% 98% 2.3 42% 69.7 Western Sussex Hospitals NHS Trust St Richard's Hospital 805 17 87% 100% 2.4 40% 72.4 ∆ ∆ Worthing Hospital 27 4 26% 89% 2.1 21% 74.4

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

23 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 West Hertfordshire Hospitals NHS Trust St Albans City Hospital 630 9 97% 98% 2.1 41% 70.6 ∆ Watford General Hospital 211 8 75% 100% 2.7 39% 75.2 ∆ Weston Area Health NHS Trust Weston General Hospital 433 9 94% 94% 2.4 40% 71.5 ∆ ∆ West Suffolk Hospitals NHS Trust West Suffolk Hospital 795 15 96% 100% 2.2 41% 71.7 Wirral University Teaching Hospital NHS Foundation Trust Arrowe Park Hospital 431 14 83% 95% 2.5 42% 72.0 Clatterbridge Hospital 608 15 88% 100% 2.1 43% 69.2 Worcestershire Acute Hospitals NHS Trust Alexandra Hospital 1177 17 97% 99% 2.3 42% 71.4 Kidderminster Treatment Centre 19 3 100% 100% 2.1 53% 71.9 Worcestershire Royal Hospital 36 6 69% 100% 2.3 44% 72.3 Wrightington Wigan and Leigh NHS Foundation Trust Royal Albert Edward Infirmary 114 21 92% 92% 2.9 46% 73.2 Wrightington Hospital 3578 33 97% 97% 2.1 44% 67.7 Wye Valley NHS Trust Hereford County Hospital 654 13 80% 99% 2.2 42% 71.9

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

24 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Yeovil District Hospital NHS Foundation Trust Yeovil District Hospital 789 9 96% 100% 2.3 42% 70.6 York Teaching Hospital NHS Foundation Trust Bridlington and District Hospital 734 11 91% 98% 2.2 45% 69.8 Scarborough General Hospital 63 7 100% 100% 2.5 40% 73.1 York Hospital 514 13 88% 99% 2.4 46% 71.9 ∆ 3fivetwo Group Kingsbridge Private Hospital (Belfast) 746 9 96% 23% 1.9 51% 68.2 Aspen Healthcare Limited Claremont Hospital () 877 23 98% 97% 1.8 44% 68.5 Highgate Hospital (London) 86 11 100% 99% 2.0 36% 65.3 Parkside Hospital (Greater London 317 17 92% 81% 1.9 43% 67.2 The Holly Private Hospital (Essex) 300 18 100% 97% 1.9 43% 67.9 ∆ Benenden Healthcare Society Benenden Hospital (Kent) 771 12 87% 96% 1.9 43% 72.2 BMI Healthcare BMI Alexandra Hospital Cheadle (Cheshire) 1092 43 94% 98% 2.2 42% 69.2 BMI Bath Clinic (Avon) 325 9 99% 100% 2.0 44% 69.4 ∆ BMI Beardwood Private Hospital 412 13 93% 99% 2.1 44% 69.2 (Lancashire) BMI Bishops Wood Hospital (Middlesex) 221 11 86% 95% 1.9 44% 69.1 ∆

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

25 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 BMI Blackheath Hospital (Greater London) 285 21 91% 95% 2.0 39% 68.4 BMI Bury St Edmunds (Suffolk) 472 5 100% 98% 1.9 43% 70.2 BMI Chaucer Hospital (Kent) 198 11 97% 98% 2.0 39% 70.0 BMI Chelsfield Park Hospital (Kent) 273 9 99% 96% 2.0 43% 69.3 BMI Clementine Churchill Hospital 358 20 97% 97% 2.0 40% 69.3 ∆ (Middlesex) BMI Coombe Wing (Surrey) 1 1 0% 100% 2.0 0% 62.5 BMI Esperance (East Sussex) 73 4 97% 96% 2.0 44% 70.9 BMI Fawkham Manor Hospital (Kent) 11 5 100% 82% 1.6 44% 65.7 BMI Goring Hall Hospital (West Sussex) 705 9 93% 99% 2.1 37% 70.3 ∆ BMI Hampshire Clinic (Hampshire) 357 12 87% 88% 2.0 42% 68.1 BMI Harrogate (North Yorkshire) 358 7 97% 91% 1.9 48% 68.4 BMI Hendon Hospital (Greater London N/A6 BMI Highfield Hospital (Lancashire) 751 24 86% 98% 2.0 41% 67.8 BMI Huddersfield (West Yorkshire) 470 6 100% 100% 2.1 44% 68.1 BMI Kings Oak Hospital (Middlesex) 119 17 84% 92% 2.1 42% 70.4 BMI Lancaster (Lancashire) 246 8 100% 93% 1.8 42% 70.6 BMI Lincoln (Lincolnshire) 463 11 99% 99% 2.1 39% 69.6 BMI Manor Hospital (Bedfordshire) 259 7 100% 98% 1.9 48% 69.0 BMI Mount Alvernia Hospital (Surrey) 280 9 99% 96% 1.9 46% 69.4 BMI Princess Margaret (Berkshire) 310 13 97% 94% 1.8 46% 67.4

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

26 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 BMI Priory Hospital (West Midlands) 326 16 98% 96% 1.9 42% 67.6 BMI Ridgeway Hospital (Wiltshire) 438 8 99% 99% 2.0 47% 67.1 BMI Runnymede Hospital (Surrey) 203 12 97% 97% 1.9 43% 68.7 BMI Sandringham Hospital (Norfolk) 408 7 99% 99% 2.3 44% 70.3 BMI Sarum Road Hospital (Hampshire) 304 6 98% 99% 2.0 47% 70.5 BMI Saxon Clinic (Buckinghamshire) 459 5 86% 93% 1.9 45% 68.4 BMI Shirley Oaks Hospital (Surrey) 96 12 56% 98% 2.2 49% 68.3 BMI The Beaumont Hospital (Lancashire) 308 7 91% 96% 2.0 42% 67.5 BMI The Cavell Hospital (Middlesex) 401 14 96% 99% 1.9 37% 69.3 BMI The Chiltern (Buckinghamshire) 664 10 100% 94% 2.0 43% 69.6 BMI The Droitwich Spa Hospital 391 18 100% 100% 1.9 42% 69.2 (Worcestershire) BMI The Edgbaston Hospital (West 330 19 76% 70% 1.8 56% 64.7 Midlands) BMI The Harbour Hospital (Dorset) 253 10 99% 98% 2.0 43% 70.6 BMI The London Independent Hospital 148 12 81% 87% 2.0 40% 65.2 ∆ (Greater London) BMI The Meriden Hospital (West Midlands) 447 19 94% 93% 1.9 48% 66.5 ∆ ∆ ∆ ∆ BMI The Park Hospital (Nottinghamshire) 694 22 86% 96% 2.2 44% 68.8 BMI The Sloane Hospital (Kent) 116 10 89% 95% 2.1 49% 69.8 BMI The Somerfield Hospital (Kent) 35 6 100% 97% 2.1 53% 69.9 BMI The South Cheshire Private Hospital 128 9 99% 97% 1.9 43% 68.8 (Cheshire)

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

27 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 BMI Thornbury Hospital (South Yorkshire) 752 21 99% 98% 2.0 46% 67.3 BMI Three Shires Hospital 860 11 100% 99% 2.1 42% 68.4 (Northamptonshire) BMI Werndale Hospital (Carmarthenshire) 418 11 100% 100% 2.0 43% 70.4 BMI Winterbourne Hospital (Dorset) 460 7 100% 99% 2.0 39% 70.9 BMI Woodlands Hospital (County Durham) 790 11 95% 96% 1.8 45% 67.4 Bupa Group Bupa Cromwell Hospital (Greater London) 329 18 84% 62% 1.7 53% 67.5 Care UK Barlborough NHS Treatment Centre 1691 20 100% 100% 2.0 45% 69.9 ∆ (Derbyshire) Emersons Green NHS Treatment Centre 1000 13 98% 98% 1.9 42% 68.8 (Avon) North East London NHS Treatment Centre 548 8 100% 100% 2.2 41% 68.4 (Essex) Peninsula NHS Treatment Centre (Devon) 1331 18 99% 100% 2.1 43% 69.5 Shepton Mallet Treatment Centre 1324 15 100% 100% 2.0 45% 70.7 (Somerset) Southampton NHS Treatment Centre 614 14 95% 97% 2.0 38% 69.1 (Hampshire) Circle Circle Bath Hospital (Avon) 1048 17 93% 99% 1.9 42% 68.4 Circle Reading (Berkshire) 716 18 86% 97% 1.9 42% 66.9

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

28 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 East Kent Medical Services Ltd Spencer Private Hospitals - Margate (Kent) 414 6 86% 99% 2.1 42% 70.1 Fairfield Hospital Fairfield Hospital (Merseyside) 397 10 97% 96% 2.1 50% 68.0 Fortius Clinic Fortius Clinic (London) N/A6 HCA International Ltd London Bridge Hospital (London) 367 26 81% 69% 1.8 52% 62.8 The Lister Hospital (London) 71 11 97% 65% 1.9 33% 67.1 ∆ The Princess Grace Hospital (London) 461 23 92% 76% 1.9 46% 66.8 The Wellington Hospital (London) 186 16 100% 88% 1.8 49% 60.9 Healthcare Management Trust Sancta Maria Hospital (West Glamorgan) 413 6 92% 96% 2.1 40% 69.7 St Hugh's Hospital (North East 672 11 97% 100% 2.2 40% 69.7 Lincolnshire) Horder Healthcare The Horder Centre (East Sussex) 2075 18 99% 99% 1.9 41% 70.7 Hospital of St John and St Elizabeth Hospital of St John and St Elizabeth 160 17 81% 79% 2.2 46% 67.9 (Greater London) KIMS Hospital KIMS Hospital (Kent) 1319 25 100% 99% 2.1 44% 69.1

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

29 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 King Edward VII Hospital Sister Agnes King Edward VII Hospital Sister Agnes 622 18 79% 73% 1.9 47% 68.3 ∆ ∆ (Greater London) North West Independent Hospital North West Independent Hospital (County 253 7 97% 70% 1.9 45% 69.7 Londonderry) Nuffield Health Nuffield Health Bournemouth Hospital 430 9 100% 97% 2.0 38% 70.8 (Dorset) Nuffield Health Brentwood Hospital (Essex) 411 12 100% 96% 2.0 47% 68.8 Nuffield Health Brighton Hospital (East 136 7 99% 98% 1.9 49% 67.8 Sussex) Nuffield Health Bristol Hospital (Avon) 297 11 95% 92% 2.0 48% 67.8 Nuffield Health Cambridge Hospital 577 13 96% 94% 1.9 40% 68.3 (Cambridgeshire) Nuffield Health Cheltenham Hospital 339 12 96% 96% 1.9 47% 71.1 ∆ (Gloucestershire) Nuffield Health Chichester Hospital (West 491 9 98% 95% 2.0 38% 71.7 ∆ Sussex) Nuffield Health Derby Hospital (Derbyshire) 1125 19 99% 99% 2.0 45% 67.7 Nuffield Health Exeter Hospital (Devon) 347 12 94% 90% 1.9 46% 71.7 Nuffield Health Guildford Hospital (Surrey) 170 10 97% 91% 2.1 36% 73.2 Nuffield Health Haywards Heath Hospital 219 7 99% 98% 1.9 47% 69.3 (West Sussex) Nuffield Health Hereford Hospital 514 8 95% 97% 2.1 46% 70.5 (Herefordshire)

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

30 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Nuffield Health Ipswich Hospital (Suffolk) 353 5 100% 99% 1.9 35% 72.1 Nuffield Health Leeds Hospital (West 888 22 90% 90% 2.0 50% 66.5 Yorkshire) Nuffield Health Leicester Hospital 545 18 99% 97% 2.0 41% 68.7 (Leicestershire) Nuffield Health Newcastle-upon-Tyne 756 18 98% 94% 1.8 43% 67.2 Hospital (Tyne & Wear) Nuffield Health North Staffordshire Hospital 812 10 99% 97% 2.0 43% 68.2 (Staffordshire) Nuffield Health Plymouth Hospital (Devon) 604 10 99% 98% 2.0 45% 68.8 Nuffield Health Shrewsbury Hospital 330 10 100% 99% 1.9 44% 68.3 (Shropshire) Nuffield Health Taunton Hospital (Somerset) 458 10 97% 96% 2.2 44% 70.5 Nuffield Health Tees Hospital (County 859 12 100% 100% 1.9 43% 67.1 Durham) Nuffield Health The Grosvenor Hospital 337 10 100% 100% 1.8 48% 69.0 (Cheshire) Nuffield Health The Manor Hospital 739 15 95% 86% 1.9 42% 67.7 (Oxfordshire) Nuffield Health Tunbridge Wells Hospital 158 5 99% 82% 2.0 49% 69.8 (Kent) Nuffield Health Warwickshire Hospital 573 18 97% 97% 1.9 45% 69.4 (Warwickshire) Nuffield Health Wessex Hospital 838 17 99% 96% 2.0 47% 68.2 (Hampshire) Nuffield Health Woking Hospital (Surrey) 151 10 95% 94% 1.8 44% 67.4

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

31 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Nuffield Health Wolverhampton Hospital 382 9 99% 98% 1.9 43% 70.0 (West Midlands) Nuffield Health York Hospital (North 535 11 100% 100% 1.9 47% 70.0 Yorkshire) Vale Hospital (Glamorgan) 849 23 98% 98% 1.9 44% 67.2 One Ashford Healthcare Ltd One Ashford Willesborough (Kent) 508 14 94% 99% 2.0 44% 69.7 One Hatfield Hospital (Hertfordshire) 139 12 85% 97% 2.0 40% 67.9 Orthopaedic Spine and Specialist Hospital Orthopaedics and Spine Specialist Hospital 37 1 97% 100% 2.1 30% 68.0 ∆ (Cambridgeshire) Ramsay Health Care Ashtead Hospital (Surrey) 180 8 99% 98% 2.0 38% 70.7 ∆ Duchy Hospital (Cornwall) 1279 12 99% 99% 2.0 42% 70.3 Euxton Hall Hospital (Lancashire) 377 12 100% 99% 2.0 48% 68.1 Fitzwilliam Hospital (Cambridgeshire) 1011 15 98% 99% 2.0 44% 68.6 ∆ ∆ Fulwood Hall Hospital (Lancashire) 682 9 96% 100% 2.0 43% 68.8 Mount Stuart Hospital (Devon) 602 11 96% 99% 2.0 41% 69.1 New Hall Hospital (Wiltshire) 677 9 96% 98% 1.9 41% 70.5 North Downs Hospital (Surrey) 322 10 98% 98% 1.9 40% 69.5 ∆ Nottingham Woodthorpe Hospital 654 10 96% 100% 2.2 43% 68.3 (Nottinghamshire) Oaklands Hospital (Lancashire) 521 15 93% 97% 2.0 45% 66.0

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

32 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Oaks Hospital (Essex) 686 10 99% 97% 1.9 40% 70.4 Park Hill Hospital (South Yorkshire) 570 9 100% 99% 2.1 41% 68.4 Pinehill Hospital (Hertfordshire) 492 12 99% 99% 1.9 38% 69.3 Renacres Hall Hospital (Lancashire) 384 8 100% 99% 1.9 46% 69.9 Rivers Hospital (Hertfordshire) 588 8 96% 89% 1.9 43% 68.4 Rowley Hall Hospital (Staffordshire) 485 7 98% 99% 2.0 39% 68.0 Springfield Hospital (Essex) 1035 10 90% 93% 2.0 44% 69.0 ∆ ∆ Tees Valley Hospital (North Yorkshire) 400 7 77% 100% 1.9 41% 69.1 The Berkshire Independent Hospital 215 7 94% 98% 2.0 48% 68.9 (Berkshire) The Yorkshire Clinic (West Yorkshire) 1020 15 98% 98% 2.1 44% 69.1 West Midlands Hospital (West Midlands) 232 8 100% 100% 2.2 45% 69.7 Winfield Hospital (Gloucestershire) 709 13 93% 96% 1.9 41% 69.6 Woodland Hospital (Northamptonshire) 1026 10 100% 100% 2.2 43% 68.2 Clifton Park Hospital (North Yorkshire) 637 12 100% 99% 1.9 42% 70.7 Horton NHS Treatment Centre 1074 15 100% 100% 2.1 41% 69.4 ∆ (Oxfordshire) Schoen Clinic London Ltd Schoen Clinic London (London) 364 11 96% 77% 1.8 50% 67.5 Spire Healthcare Spire Alexandra Hospital (Kent) 475 12 94% 98% 2.2 44% 67.4 Spire Bristol Hospital (Avon) 974 24 100% 98% 2.0 42% 67.6

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

33 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Spire Bushey Hospital (Hertfordshire) 655 23 96% 91% 1.9 41% 68.8 Spire Cambridge Lea Hospital 723 18 100% 99% 1.8 43% 67.8 (Cambridgeshire) Spire Cardiff Hospital (Glamorgan) 468 19 100% 96% 2.0 45% 68.1 Spire Cheshire Hospital (Cheshire) 516 15 100% 99% 2.0 47% 67.3 Spire Clare Park Hospital (Surrey) 376 9 66% 95% 2.0 44% 68.0 Spire Dunedin Hospital (Berkshire) 148 7 90% 99% 1.9 37% 68.0 Spire Elland Hospital (West Yorkshire) 577 14 100% 98% 2.1 46% 69.7 Spire Fylde Coast Hospital (Lancashire) 627 11 98% 98% 2.1 47% 70.1 Spire Gatwick Park Hospital (Surrey) 378 10 98% 99% 2.1 42% 69.7 Spire Harpenden Hospital (Hertfordshire) 606 14 100% 98% 2.0 42% 68.8 Spire Hartswood Hospital (Essex) 404 15 86% 93% 1.9 44% 67.7 Spire Hull and East Riding Hospital (East 892 20 91% 97% 2.1 40% 68.3 ∆ Yorkshire) Spire Leeds Hospital (West Yorkshire) 651 21 89% 97% 2.1 41% 68.8 Spire Leicester Hospital (Leicestershire) 952 18 98% 100% 2.1 42% 67.9 Spire Little Aston Hospital (West Midlands) 864 22 100% 99% 2.1 44% 68.5 Spire Liverpool Hospital (Merseyside) 591 11 96% 99% 2.1 45% 66.8 ∆ Spire London East Hospital (London) 157 10 83% 97% 2.0 37% 67.5 Spire Manchester Hospital (Lancashire) 512 27 100% 97% 2.0 43% 65.6 Spire Methley Park Hospital (West 564 9 100% 99% 2.1 50% 67.1 Yorkshire) Spire Montefiore Hospital (East Sussex) 560 11 95% 94% 1.9 44% 68.9

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

34 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 Spire Murrayfield Hospital (Merseyside) 474 9 100% 100% 1.9 42% 67.6 Spire Norwich Hospital (Norfolk) 1366 15 94% 97% 2.0 44% 69.9 Spire Nottingham Hospital 315 10 78% 97% 2.2 49% 69.2 (Nottinghamshire) Spire Parkway Hospital (West Midlands) 666 17 97% 99% 1.9 36% 68.3 Spire Portsmouth Hospital (Hampshire) 766 17 92% 88% 1.9 39% 68.9 Spire Regency Hospital (Cheshire) 477 9 94% 98% 1.9 44% 70.2 Spire Southampton Hospital (Hampshire) 1178 17 96% 91% 1.9 49% 68.2 ∆ ∆ Spire South Bank Hospital (Worcestershire) 533 10 99% 95% 1.9 42% 69.8 Spire St Anthonys (Surrey) 331 15 95% 90% 2.0 42% 68.6 Spire Sussex Hospital (East Sussex) 368 6 98% 98% 2.0 39% 70.8 Spire Thames Valley (Berkshire) 145 13 92% 88% 1.8 36% 69.6 Spire Tunbridge Wells Hospital (Kent) 104 8 98% 98% 1.8 50% 67.1 Spire Washington Hospital (Tyne & Wear) 732 19 95% 93% 1.9 45% 67.0 Spire Wellesley Hospital (Essex) 582 10 97% 96% 2.1 38% 69.7 Spire Yale Hospital (Wrexham) 418 15 84% 92% 2.0 39% 71.4 St Josephs Hospital St Josephs Hospital (Gwent) 594 15 98% 97% 1.9 44% 70.0 The London Clinic The London Clinic (London) 289 17 98% 68% 1.6 42% 60.7 The New Foscote Hospital Limited The New Foscote Private Hospital 58 2 83% 100% 1.9 55% 69.4 (Oxfordshire)

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

35 www.njrcentre.org.uk National Joint Registry | 17th Annual Report

Trust/Local Health Board/Company Outliers: Hips Outliers: Knees Average Number of Number of Consent Average Percentage age at Revision Revision Revision Revision procedures consultants rate (%) Linkability ASA grade (%) male operation 90-day rate since rate since 90-day rate since rate since Hospital 2019 2019 20191 (%) 20192 2019 2019 2019 mortality3 20104 20155 mortality3 20104 20155 The New Victoria Hospital Limited The New Victoria Hospital (Surrey) 134 10 95% 97% 2.1 31% 71.5 The Ulster Independent Clinic Ulster Independent Clinic (Belfast) 704 21 100% 95% 1.9 42% 70.9

Please note for the data in the following table: Consent and Linkability are: Red if lower than 80% Amber if equal to or greater than 80% and lower than 95% Green if 95% or more • Linkability for some hospitals will be lower than expected if they have private patients from outside England and Wales • Data covers procedures carried out between 1 January 2019 and 31 December 2019 Outlier analyses are: Red if units are above the upper of the 99.8% control limits (approximates to 3 standard deviations (SDs)) Green if units are within the expected range

The table uses the following footnotes: 1 Consent rate - percentage of cases submitted to the NJR with patient consent confirmed. 2 Linkability - the proportion of records which include a valid NHS number compared with the number of procedures recorded on the NJR. 3 Outliers with respect to 90-day mortality following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 4 Outliers with respect to revisions (at any time) following primary operations performed from 2010 onwards [from 15 February 2010 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 5 Outliers with respect to revisions (at any time) following primary operations performed from 2015 onwards [from 15 February 2015 to 14 February 2020 inclusive]. Units above the upper of the 99.8% control limits (approx 3 SDs) are flagged in red (∆). 6 Hospital has not submitted data.

36 www.njrcentre.org.uk